Articles tagged with Insurance
Researchers analyzed electronic health records from over 39,000 adults with diabetes, finding that those who lost insurance had poorer blood sugar control and needed more intensive medications. The study suggests that coverage gaps pose a direct threat to health, particularly for low-income patients.
Researchers developed a nonparametric statistical inference theory for integrals of quantiles, applicable to various data settings. The framework offers unified large-sample arguments for classical estimators and insights into conditions for asymptotic results.
Researchers found that less transparency in bond markets can lead to better economic outcomes, as it imposes discipline on players and makes institutions more selective about bonds they buy. This is in contrast to the 2008 global financial crisis, which was triggered by too much public information and looser credit.
A recent study predicts that nearly 1 in 10 Medicare Advantage beneficiaries will be forced to disenroll from their current plans in 2026. The drivers of these disenrollments include changes to plan payments and risk adjustment, as well as unanticipated increases in healthcare use among Medicare Advantage enrollees.
A new study published in Risk Sciences investigates the potential of big data and modern predictor-selection methods to improve health insurance risk assessment. The analysis reveals that adding big data, particularly from smartphone use, improves out-of-sample prediction compared to traditional underwriting information.
A new three-dimensional framework organizes how risks are studied and managed, focusing on identification and assessment, mechanism and strategy, and behavior and decision. This framework brings together perspectives from diverse fields to better understand complex risks.
A study published in the New England Journal of Medicine found that children whose parents were injured by firearms experience substantial mental health impacts, with a 42% increase in psychiatric diagnoses and 60% increase in mental health visits. Early, targeted interventions are needed to address this growing need.
Drivers who participated in a program based on their driving habits showed reduced speeding, hard braking, and rapid acceleration by up to 25%. They continued these safe habits even after the program ended. The programs were equally effective in improving safety scores.
A new study finds that hospitals treating more patients with Medicare Advantage plans face higher readmission penalties despite taking similar actions to prevent repeat hospitalizations. The analysis highlights the need to incorporate Medicare Advantage data into the Hospital Readmissions Reduction Program.
A new report highlights the growing impact of climate-related disruptions on global supply chains, which are increasingly exposed to climate-related shocks. The sector's inability to manage systemic risk may undermine stability and amplify climate stress unless substantial changes are made to business models and regulation.
A US study of over a million Medicaid enrollees reveals major gaps in access to medication-based addiction treatments, particularly for Black patients. Methadone and buprenorphine show significant overdose risk reductions, highlighting the need for policy reforms to ensure timely access.
A new study found that access to wheelchairs through Medicare-listed suppliers is inconsistent and often challenging due to administrative requirements and long delivery timelines. The research highlights the need for policy changes to assist vulnerable older adults in accessing critical medical equipment.
Researchers warn that Medicaid funding cuts will have significant spillover effects on children's health due to a lack of consideration for their coverage. Experts suggest policies such as loan repayment and increased investment in pediatric workforce development can help mitigate the issue.
A University of Michigan study found that Medicaid coverage is linked to employment gains among low-income adults with serious health problems. Employment nearly doubled among enrollees who experienced improved health, from 26% to 47%. This suggests that Medicaid expansion may actually help individuals participate in the workforce.
JMIR Publications invites submissions on navigating AI-enabled uncertainty in healthcare management, with a focus on practical guidance for senior management and administrators. The theme issue explores topics such as AI-enabled reimbursement, cloud migration, and vendor dynamics.
Researchers found that Medicaid accountable care organizations (ACOs) can improve some maternal health outcomes if designed thoughtfully. The study highlights the importance of value-based care delivery design within Medicaid programs to support low-income women before, during, and after pregnancy.
A study by University of Arizona researchers found that selecting the right data for flood insurance can significantly improve accuracy, speed, and predictability. The type of data used affects not only payout timing but also confidence in anticipating future payouts, influencing program costs.
Research at UCLA Health Sciences found that high-markup hospitals charge up to 17 times the true cost of care, resulting in poorer patient outcomes, including higher complication and readmission rates. Patients treated at these hospitals often experience financial toxicity or medical bankruptcy.
Dr. Alan Sager presents a guide to thorough healthcare reform in the US, citing high costs and inadequate insurance coverage as major issues. He proposes solutions such as containing costs safely, insuring all Americans, and securing adequate pay for doctors and hospitals.
A new study from Ann & Robert H. Lurie Children's Hospital of Chicago highlights the urgent need for better Medicaid coverage for anorexia care after hospitalization. The research reveals that Medicaid-insured patients with anorexia hospitalized for medical stabilization remain in the hospital longer than peers with private insuran...
A new University of Michigan study found that critically ill patients without health insurance are less likely to receive inter-hospital transfers for treatment, leading to higher mortality rates. Patients with commercial insurance have a significantly lower risk of death compared to those without insurance or with Medicare/Medicaid.
Among youth aged 15-24, polysubstance-involved opioid overdose deaths rose steadily with age, driven by fentanyl and synthetic opioids. By age 21, polysubstance involvement surpassed opioid-only fatalities, primarily due to stimulants like methamphetamine and cocaine.
Researchers developed a customized parametric insurance system using Probabilistic Tsunami Risk Assessment (PTRA) to quantify tsunami losses and payouts. The proposed framework reduces overpayment by 60.9% while maintaining risk reduction, potentially saving lives and money.
Two studies from University of Michigan researchers suggest many older adults and people with disabilities need more impartial help picking the best Medicare plan. Only about 13% of enrollees switch plans annually, and even fewer use the internet to research options.
A study by researchers at UCSF found that young patients who received eight or more outpatient therapy sessions after a hospital stay were 25 times less likely to be readmitted. The therapy was delivered by community-based clinicians and did not require specialist expertise. This simple yet effective approach has the potential to break...
A cross-sectional study found that stronger gun laws were associated with lower overall firearm mortality, particularly for suicide. Policies addressing root causes of violence through economic mobility and social services may also reduce homicides.
A new study found that almost all Medicaid managed care plans (MCPs) cover at least one form of naloxone, with 94% covering generic injectables or 4-mg nasal sprays. However, certain restrictions and quantity limits may prevent people from accessing this life-saving drug.
A new analysis examines the effectiveness of a Centers for Medicare and Medicaid Services (CMS) add-on code targeting infectious disease (ID) physicians. The measure aims to combat the growing shortage of ID physicians and has the potential to reset national benchmarks for ID compensation.
The health care workforce experienced decreased employment growth during the pandemic but fully recovered by 2024. This unique recovery is attributed to health care financing via insurance coverage that shielded health care employment from macroeconomic fluctuations.
A new study found that problems with accessing high-quality care were a major driver for switching Medicare Advantage plans, not cost concerns. Dissatisfaction with medical care access was more common among those in poor health, and those who enrolled in MA plans with low star ratings were also more likely to switch.
A new study projects that wind losses for homeowners in the Southeast will increase by 76% by 2060 and 102% by 2100. Texas is expected to experience the highest increase in losses, followed by Louisiana, Mississippi, and Alabama.
A new study reports a substantial increase in mental health and neurodevelopmental disorder diagnoses among publicly insured children between 2010-19. The percentage of diagnoses rose from 10.7% to 16.5%, with a significant increase observed even before the COVID-19 pandemic began.
A new University of Michigan study suggests that Medicaid unwinding may have disrupted the care of people receiving treatment for opioid addiction. Patients were less likely to continue filling buprenorphine prescriptions and more likely to pay with cash or private insurance in states with large versus small Medicaid enrollment drops.
A recent FAU survey found that most Floridians are concerned about rising insurance premiums due to climate change, with nearly two-thirds worried about affordability. The survey also reveals strong support for addressing climate change, expanding renewable energy, and teaching climate science in schools.
An analysis of differential coding patterns between Medicare Advantage (MA) and Traditional Medicare (TM) plans estimated that MA plans received an estimated $33 billion in additional revenue due to coding differences. The study found that UnitedHealth Group received the most additional revenue, with a $1,863 increase per member.
A new paper highlights emerging alternatives to traditional diabetes medicines, such as continuous glucose monitors and lifestyle interventions like GEM, which can improve patient adherence and long-term health outcomes.
The study found that nearly 1-in-3 young people now live with pediatric onset conditions that significantly affect their lives. Young adults are more likely to develop chronic conditions if they have lower socioeconomic status.
A new dynamic percolation model assesses the upper bounds of losses for drone swarms under cyberattacks, considering system parameters such as signal strength and node vulnerability. The study finds that optimized allocation of defense resources and improved communication protocols can significantly reduce losses.
A new framework for endowment contingency funds ensures equitable compensation among participants by pooling contributions and distributing resources upon adverse events. The framework's mathematical modeling reveals that as the pool approaches infinity, the distribution of payouts converges to traditional insurance mechanisms.
US outpatient prescriptions for ivermectin and hydroxychloroquine increased significantly during the COVID-19 pandemic, with usage being three times higher among adults aged 65 and older. The study's findings highlight the need for policy reforms to combat misinformation and mistrust in scientific institutions.
A recent study found that telehealth is closing the care gap for people with substance use disorder in rural areas, but those covered by Medicaid managed care have lower access to this treatment. Rural individuals experienced the greatest overall increase in substance use disorder treatment among all populations studied.
A study by Brown University researchers found that nearly half of primary care providers in the US are affiliated with hospitals or private equity firms, resulting in higher charges. These affiliations were linked to a 10.7% increase in negotiated prices for office visits compared to independent practices.
A new study found disparities in access to semaglutide based on insurance plan, job industry, sex, and other factors. Individuals with female identities, preferred provider organization coverage, and antidepressant use were more likely to start taking semaglutide compared to males or those with certain employment industries.
Researchers at UMass Amherst developed a model that quantifies the impacts of social factors on HIV spread, finding that addressing barriers to treatment and care can reduce national HIV incidence by 29%. The study suggests that investing in prevention and social programs could be more cost-effective than treatment alone.
A cohort study found that insurance plan type and structure play a crucial role in determining access to semaglutide for adults with obesity. The findings suggest that targeted interventions at the insurance level could improve equity in obesity treatment access.
A new study found that Medicare Advantage patients with colorectal cancer are six percentage points less likely to receive a cancer drug compared to those on Traditional Medicare. For non-small cell lung cancer, the pattern was not as clear due to limited low-cost treatment options.
Pharmacy benefit managers (PBMs) steer Medicare patients to their own pharmacies, with PBM-owned pharmacies capturing over 60% market share in certain drug classes. The study suggests that the 'any willing pharmacy' rules may be preventing PBMs from gaining significant market share in Medicare.
Research reveals that long COVID affects not only job status but also overall well-being, leading to financial instability, emotional distress, and feelings of loss of identity. Patients report struggling to cope with lingering symptoms and facing skepticism from healthcare providers.
A new study reveals that lower-quality public housing units are disproportionately located in areas with high flood risk, putting residents at risk of catastrophic damage. The research also highlights the disproportionate impact on people of color and those with limited ability to recover from flooding.
Researchers found a 10.8% price discount in the AEP 100 flood zone and a 4.4% discount in the AEP 500 flood zone, highlighting the financial burden of flood risk on homebuyers. The study emphasizes the need for policymakers to safeguard communities and manage real estate markets as climate patterns intensify.
Continuous Medicaid enrollment is associated with a lower rate of late-stage lymphoma diagnosis, but fewer than half of patients are continuously enrolled before diagnosis. The study found that continuous coverage was strongly linked to a lower likelihood of late-stage diagnosis, especially in young adults.
The study reveals that many individuals and households incur significant financial burdens for abortion care, with those traveling from out of state facing the most extreme costs. To address this issue, expansion of insurance coverage to ensure equitable access to abortion care is needed, regardless of a person's state of residence.
A new study by MIT scholars finds that hospice care generates substantial savings for the US Medicare system, with $29,000 in cost savings over five years for patients with Alzheimer's Disease. Hospice care provides palliative-type care at a lower cost than elaborate medical procedures, saving lives and reducing suffering.
A study by Ohio State University found that ground ambulance providers raised their prices in response to a New York law aimed at preventing surprise, expensive out-of-network emergency ambulance bills. The law increased prices by 13%, which is likely to hit health consumers' bank accounts through elevated insurance premiums.
A cross-sectional study of 14,000 insured adults found that individual-level social determinants of health are strongly linked to healthcare spending by Medicare, Medicaid, and private insurers. This association can inform health insurers and policymakers to incorporate social determinants into decision-making practices.
A new study found that 3% of people with traditional Medicare switch to Medicare Advantage each year, but many switch back after a short period. The researchers discovered that people who switched from MA to traditional Medicare were more likely to choose higher-rated plans or those with broader networks.
A study led by UMass Amherst found no significant improvement in asthma care for Medicaid-insured children compared to those with private insurance. Despite the launch of primary care-oriented Medicaid ACOs in Massachusetts, disparities in quality of care persist, with worsening emergency department/hospital use for children with Medic...
A new study published in JAMA Network Open found that racial and ethnic minorities are more likely to have claims for free preventive care denied by insurance plans, leading to unexpected bills or lack of access. Healthcare providers also charge disadvantaged groups a higher amount for preventive services.
A new study reveals the flood insurance program's effects differ greatly among communities, with higher-population and wealthier areas benefiting more from discounts on premiums. Lower-income communities also see benefits, but only in areas with less racial and ethnic diversity, realizing a gain of about $6,000 per household.
A study with 4.8 million Medicaid enrollees found that policies requiring 12-month supply of contraception have not been fully implemented, resulting in no substantial increases in year-long prescription orders. This leaves many patients at an increased risk for unintended pregnancy.